Gingivectomy-Clinical Case

The gingivectomy is perhaps the oldest surgical procedure used in periodontics. By definition, it means cutting away gingiva (gum). Early in the century this surgery was used to attempt pocket reduction, but unfortunately the gums would often grow back to their original position. Not until the early 1950's did periodontists realize that when periodontal infection caused irregular bone loss, a common occurrence, the gingivectomy was of limited value. Today this procedure is used in very early cases, or in cases of pure tissue overgrowth that sometimes is a side effect of poor oral hygiene or of certain medications (Dilantin, calcium channel blockers, etc.). Whenever used, the surgeon must be sure there is adequate attached gingiva left after tissue removal, to assure gingival recession will not occur (See Gum Recession). The following case shows early pocketing, without irregular bony loss, and an adequate band of attached gingiva. Removing some of the excess tissue reduced the pocket depth so the patient could access and remove plaque from the area with normal home brushing and flossing.

 
Probe at gum edge Probe in 5mm pocket
5mm pocket on adjacent tooth
   
Trimming away excess tissue (note still adequate hard gum left) Gingivectomy completed
 
Healing after four weeks Healing at 8 weeks. Tissue completely blended to normal contour. Notice plaque and calculus at necks of teeth. Patient home care must improve.